Sustainable Sanitation and Hygiene For All Programme Progress Update: December 2016: Zambia By December 2016, 364,317 people had gained access to new and improved latrines in the Northern Province since 2014 under the Sustainable Sanitation and Hygiene For All Results Programme (SSH4A-RP) implemented by SNV, the government of Zambia and with funding from UKAID. The Sustainable Sanitation and Hygiene for All (SSH4A) is SNV s approach to ensure equitable and sustainable access to improved and hygiene. We do this by supporting district-wide rural and hygiene services. Developed since 2008 in Asia, the SSH4A approach is currently being implemented and scaled up across 15 countries in Asia and Africa. The SSH4A Programme integrates best practices in demand creation and supply chain strengthening, hygiene behaviour change communication, governance, gender and social inclusion. SNV focuses on strengthening the capacities of local stakeholders to plan, implement, monitor and sustain and hygiene interventions. The SSH4A-RP is funded by UKAID under the WASH Results Programme using a results-based funding (RBF) modality. RBF is a type of Payment By Results (PbR) used by the UKAID that makes payments contingent on the independent verification of results. This brief presents a summary of progress on the SSH4A-RP in Zambia from the third midterm survey conducted in December 2016 against a baseline done in 2014 at the household level. The brief also gives an overview of the programme s impact on poverty, gender and people living with disabilities. Mporokoso 41% Luwingu 35% Mungwi 70% Kasama 34% Figure 1: Overview of progress in Zambia according to district Country context The Zambian government launched the National Rural Water Supply and Sanitation Programme (NRWSSP) in 2009 to reduce open defection through increasing access to and hygiene. The programme aims to achieve (i) 60% of the rural population with access to adequate toilets, sufficient, adequate handwashing facilities within or next to toilets by 2015, and (ii) open defecation-free (ODF) status by 2020. The SSH4A Results Programme seeks to contribute to the attainment of NRWSSP targets in the districts of Kasama, Luwingu, Mporokoso and Mungwi where it is being implemented. 1
SSH4A Programme Impact End 2016 Outcome Indicator 1: Access to facilities This indicator is measured at the household level. It assesses access to new and improved latrines within the project areas using a ladder (Figure 2). Level 5: Enviromentally safe Level 4: Improved toilet, fly management Level 3: Improved toilet Level 2: Unimproved toilet Level 1: Shared toilet Level 0: No toilet/open defecation Figure 2: The ladder representing scale of access to facility By the third midterm review 364,317 people had gained new and improved access to Open defecation had reduced to 7% from a baseline of 50% Access to facilities against wealth quintiles The poorest wealth quintile registered a 77% reduction in open defecation by the third midterm review from a baseline of 91%. Among poor households, coverage (Level 3 and above) d by 50% from 7% at baseline Open defecation rates remained higher among the poorest wealth quintile, but reduced significantly within the richest quintile at the third midterm review. This shows a direct correlation between the level of wealth and access to as well as the type of toilets owned. Access to facilities among households with people living with disability Marginal unimproved facilities in households with people with disability were realised from 21% to 25% at baseline and third midterm review Among households with people living with disabilities, access to improved toilets with fly management and environmentally safe toilets d 3% from 38% at the third midterm review Access to facilities against gender of the household head Access to improved toilets among female-headed households improved by 53% across all districts from nil at the baseline Among female-headed households, open defecation was found to be at 9% at the third midterm from a baseline of 56% Access to improved toilets with fly management and environmentally safe toilets among female-headed households d by 29% from nil at the baseline across the four districts Open defecation rates are higher among female-headed households compared to male-headed households. Female-headed households made less progress towards improvements in coverage than male-headed households. This is likely due to the lack of access to labour especially for the do-it-yourself aspect of toilet construction. Low levels of income could also be a factor among female-headed households. Sustained use of facilities This indicator measures the number of people with access to a facility and are able to use it as intended. Sustained use of toilets d to 51% from 31% at baseline within the programme area. Female-headed households registered a 49% in the sustained use of latrines from 30% at the baseline Outcome Indicator 2: Hygienic use and maintenance of facilities This indicator is measured at the household level. It assesses whether a toilet is used and maintained as intended. It also measures the hygienic use and maintenance of facilities using a ladder as shown in Figure 3. Level 4: Functional, clean and private toilet Level 3: Functional and clean toilet Level 2: Functional toilet Level 1: Toilet in use as a toilet Level 0: No toilet/toilet not ion use Figure 3: Scale of hygenic use and maintenance of toilets 2
Overall hygienic use and maintenance of facilities 50% of households with toilets were found to be functional, clean and private during the third midterm review, compared to a baseline of 7% Among the poor, the proportion of households that did not have, or were not using toilets reduced to 16%, from 78% at baseline Only 15% of the households with people living with disability had no toilet, down from a baseline of 58% in the third midterm review 60% of households with people living with disability registered improvement functional, clean and private toilets from 53% at the baseline Wealth is a factor in determining use and maintenance. The richest and rich score very high on functional clean and private toilets ; they also feature the lowest in households with no toilet or toilets not being used. Hand washing is paramount in the fight against diarrhea related diseases. Sharon Mwamba, Mufumba Village, Kasama District. Outcome Indicator 3: Access to handwashing stations Measured at the household level, this indicator assesses the existence and quality of handwashing facilities in or near the toilet, and close to food preparation areas. The existence and proximity of these facilities serve as proxy indicators for the practice of handwashing after defecation and before cooking or preparing food respectively as indicated in Figure 4 below. Level 4: Handwashing station with running tap water Level 3: Handwashing station with no contamination Level 2: Handwashing station Level 1: Handwashing station with no soap Level 0: No handwashing station Figure 4: Presence of a handwashing station after defecation Knowledge of critical moments of handwashing The most significant levels of knowledge around handwashing with soap was after defecation at 31% and before eating, at 28% of households. Knowledge on handwashing after defecation improved by 3% from a baseline of 27% and before cooking/preparing food d 3% from 14% at baseline. Presence of a handwashing station next to facilities By the third midterm review, 20% of the households registered an improvement at Level 2, i.e. access to a handwashing station Handwashing stations with running water d to 13% from nil at baseline Presence of a handwashing station next to facilities by wealth quintile, gender and people living with disability The presence of handwashing stations among the poorest wealth quintile d to 26% from nil at baseline 16% of households with people living with disability had a handwashing station with running water after defecation, up from 10% at the baseline Presence of a handwashing station before cooking and food preparation by gender 94% of female-headed households did not have handwashing stations before cooking or food preparation compared to 100% at baseline reporting The presence of handwashing stations is generally low across all quintiles. This shows that the absence of handwashing is a behavioural issue, which requires campaigns. Households with people living with disability have a higher proportion of handwashing stations, but did not wash hands more before cooking or preparing food. 3
Conclusions and key recommendations All four districts have registered a high coverage by the third midterm reporting. To sustain gains made and support households progress along the ladder towards attaining environmentally safe latrines, there is a need to train Community Led Total Sanitation (CLTS) facilitators on the post Open Defecation Free (ODF) agenda. The level of sustained use of facilities was high across all four districts. In order to maintain these levels, subsequent phases of the programme will intensify hygiene campaigns. Exploring income-generating activities would be one way to enhance levels of disposable incomes within communities. This is particularly relevant among female-headed households, so that they can access labour to construct functional, clean and private toilets. Sanitation and hygiene markets ought to be strengthened in order to ensure that products and services of masons are available to all community members. This progress update was produced by the SSH4A Programme Management Unit with support from the SSH4A Country Project Team in Zambia. The results presented in this paper are based on the performance monitoring data collected, analyzed and independently verified in Zambia under the SSH4A Results Programme. SNV is a not-for-profit international development organisation. Founded in the Netherlands nearly 50 years ago, we have built a long-term, local presence in 38 of the poorest countries in Asia, Africa and Latin America. Our global team of local and international advisors work with local partners to equip communities, businesses and organisations with the tools, knowledge and connections they need to their incomes and ga basic services empowering them to break the cycle of poverty and guide their own development. This programme has been funded by UK aid from the UK government; however the views expressed do not necessarily reflect the UK government s official policies. SNV Netherlands Development Organisation 7 Nkanchibaya Road, Rhodespark P.O Box 31771 Lusaka, Zambia www.snv.org Tel: 00260 211 255 174 Email: zambia@snv.org 4
Sustainable Sanitation and Hygiene For All Programme Progress Update: December 2016: Zambia The Sustainable Sanitation and Hygiene For All Results Programme (SSH4A-RP) is based on a capacity-building approach that supports local government to lead and accelerate progress towards district-wide coverage with a focus on institutional sustainability and learning. The SSH4A-RP is being implemented within Zambia s Northern Province in Kasama, Luwingu, Mporokoso and Mungwi Districts. The findings from the 2016 third midterm review show that there has been significant progress facilities since the baseline survey was conducted in May 2014. During the third midterm review, data was collected from 1,611 households in 97 villages within 72 wards across four districts. 3% in handwashing stations after defecation among female headed households 50% in the use of functional, clean, & private toilets 51% in households with sustained use of toilets facilities 57% 9% Baseline 48% Mid-term reduction in open defecation among female headed households 77% reduction in open defection among the poorest quintile 364,317 New people gained access to improved and unimproved toilet facilities 100k People 53% in access to functional, clean & private toilets among households with people living with disabilities 26% in handwashing stations after defecation among the poorest quintile 43% reduction in households practicing open defecation 129,951 additional people washed their hands after defecation 33% decrease in households without a handwashing station